A client who has asthma (a reactive airway disease) asks the nurse about the role of leukotrienes in this process. Leukotrienes have which immune response?

The client's symptoms, along with the elevated serum amylase and lipase levels, suggest the development of acute pancreatitis as a postoperative complication. Here's a detailed explanation for why option A is the correct choice:

A) Acute pancreatitis:

Correct. Acute pancreatitis is characterized by inflammation of the pancreas, which can be triggered by various factors, including gallstones, alcohol consumption, and certain medications. In this case, the client's recent cholecystectomy for cholelithiasis (gallstones) may have led to the development of acute pancreatitis. The persistent upper abdominal pain radiating to the back, along with vomiting and fever, are classic symptoms of acute pancreatitis. Elevated serum amylase and lipase levels are common laboratory findings in acute pancreatitis due to pancreatic cell injury and leakage of these enzymes into the bloodstream.

B) Surgical site infection:

While surgical site infections are potential complications of cholecystectomy, the client's symptoms, including upper abdominal pain, vomiting, and fever, are more indicative of a systemic inflammatory process rather than localized infection at the surgical site.

C) Hepatorenal failure:

Hepatorenal failure, also known as hepatorenal syndrome, refers to kidney dysfunction that occurs as a complication of advanced liver disease. The client's symptoms and laboratory findings are not consistent with hepatorenal failure, as there are no signs of significant liver dysfunction or advanced liver disease.

D) Biliary duct obstruction:

While biliary duct obstruction can lead to symptoms similar to those of acute pancreatitis, such as upper abdominal pain and vomiting, the presence of elevated serum amylase and lipase levels strongly suggests pancreatic involvement rather than isolated biliary duct obstruction.

Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive degeneration of dopaminergic neurons in the substantia nigra of the basal ganglia. This degeneration leads to a deficiency of dopamine, a neurotransmitter involved in the regulation of movement and coordination. The inability to express oneself, as seen in the client's mumbling, can be attributed to the motor symptoms of PD, particularly bradykinesia (slowness of movement) and hypomimia (reduced facial expression), which result from dopaminergic neuron degeneration.

A) Damage to Broca's area in the temporal lobe of the brain:

Damage to Broca's area typically results in expressive aphasia, which is characterized by difficulty speaking and forming coherent sentences. While speech difficulties can occur in PD, they are primarily due to motor dysfunction rather than damage to specific language centers in the brain.

B) Degeneration of dopaminergic neurons of the basal ganglia:

Correct. Degeneration of dopaminergic neurons in the basal ganglia, particularly the substantia nigra, is the primary pathological factor in Parkinson's disease. This degeneration leads to motor symptoms such as bradykinesia, tremor, and rigidity, which can affect the client's ability to speak clearly and express himself.

C) Brain atrophy with diffuse amyloid plaques disposition:

This description is more characteristic of Alzheimer's disease, a different neurodegenerative disorder characterized by brain atrophy and the deposition of amyloid plaques. While cognitive impairment can occur in PD, the primary motor symptoms are related to dopaminergic neuron degeneration rather than amyloid plaque deposition.

D) Paralysis of the pharyngeal and epiglottal area:

Paralysis of the pharyngeal and epiglottal area can lead to dysphagia (difficulty swallowing) rather than difficulty expressing oneself verbally. While dysphagia can occur in PD, it is not typically the primary factor contributing to speech difficulties in this condition.